Uninsured receive VIP treatment in health-care pact

Palm Beach Post--July 15, 2008

By PHIL GALEWITZ

Palm Beach Post Staff Writer

Patricia Bittiker has been able to obtain medical coverage recently through a concierge medical practice. She is standing in front of her mobile home in West Palm Beach Monday.

From Project Access …

The Palm Beach County Medical Society program gives county residents short-term access to free medical care from more than 250 doctors, as well as several hospitals and other health centers, including labs and diagnostic imaging centers.

Uninsured county residents with income levels below $20,100 for an individual or $41,000 for a family of four are eligible.

For information, go to www.pbcms.org/projectaccess or call (561) 433-3940.

Last year, Patricia Bittiker of West Palm Beach was a down-and-out, self-employed bookkeeper who couldn’t afford health insurance. When she felt desperately ill, she would head to a hospital emergency room or join the long lines at the city’s 45th Street health department clinic.

Preventive care, or having a regular family doctor, was just a fantasy.

No longer. Bittiker, 60, who struggles with back pain, diabetes and lung problems, is one of 25 uninsured Palm Beach County residents getting VIP-type health care — for free.

Through MDVIP Inc., the Boca Raton-based company that runs the largest concierge medical practice in the country, Bittiker now has a regular doctor who offers her same-day appointments, hourlong exams and easy access to specialists.

For such "red carpet" treatment, MDVIP doctors normally charge a $1,500 annual membership fee.

But this year, the company agreed to form a partnership with Project Access, the Palm Beach County Medical Society’s program to provide free doctor care to uninsured low-income county residents. Under the deal, as many as 250 Project Access patients eventually will get free memberships to be treated by MDVIP doctors.

Almost one in five county residents under age 65 has no health insurance, so programs such as Project Access are meant to help plug a hole in the health-care network.

With no insurance, a person has reduced access to doctors and an increased risk of dying early from a treatable disease.

In the absence of major national or state health-care reforms, Palm Beach County health-care leaders have tried to fill the gap. The concept behind Project Access is for hundreds of private doctors to donate a couple of hours a month to uninsured patients with pressing medical needs so that no one is overburdened.

Having MDVIP, which has fought criticism since its inception that it is creating a two-tier health-care system, sign on is a boost to Project Access.

But MDVIP also is looking to show that its medical model can help more than just the rich. By focusing on prevention and easier patient access to doctors, MDVIP is trying to demonstrate that it can improve patient outcomes.

Dr. Ed Goldman, MDVIP’s chief executive, said there is still a perception that only "privileged suburbanites" get care through its practices. He insisted, however, that most of the company’s patients are middle-class people who think it’s worth paying $1,500 a year for better health care.

Of the partnership with Project Access, Goldman said, "This is a way for us to give back." With that, MDVIP is focusing on taking on uninsured patients who have chronic illnesses to see whether its brand of medicine can reduce hospital use.

Whatever the reason, Bittiker is glad to have access.

"I am so thankful," said Bittiker, who joined Project Access in November when she couldn’t find a doctor to treat her shortness of breath. Project Access got her to a lung specialist and gave her a drug discount card.

With MDVIP, which she joined in February, Bittiker now gets to call on Dr. Donald Watren, who has a family practice in West Palm Beach. Under Watren’s care, she has been diagnosed with diabetes and high cholesterol, and has been put on a rigid weight-loss program.

Like other MDVIP doctors, Watren handles about 600 patients, compared with the 2,000 to 3,000 of a typical family doctor, leaving him more time for individual patients. Bittiker, who has seen Watren eight times, has never had to wait.

"This is better than when I had insurance" in 2001, she said.

MDVIP, which launched in 2001, has 250 doctors signed up nationwide, including 22 in Palm Beach County. Together, they treat about 85,000 patients in 23 states, for an average of 340 patients per physician.

But even as the concierge medicine concept continues to grow, some critics still say doctors shouldn’t charge extra for better access. If the new MDVIP-Project Access partnership can help cut into the county’s stubborn problem of uninsured people, it could go a long way toward quieting some of those critics.

"We really appreciated MDVIP stepping forward," said Tenna Wiles, executive director of the county medical society.

About 400 county physicians participate in Project Access, which has treated 588 patients since the program started in 2005.

With an annual income of about $16,000, Bittiker said there’s no way she could afford $6,000 a year for health insurance, even if she could find a carrier that would take her with her multiple health problems.

With Project Access and MDVIP, Bittiker said, she gets to see doctors "who treat me like a human being."